title: [Cerebral hemorrhage induced by low-dose streptokinase: a pharmacologic paradox? Report of a clinical case].
abstract: A case of an important intracranial hemorrhage after a low dose (approx. 500,000 UI) of streptokinase in a 60 year-old woman suffering from myocardial infarction is presented. Clinical, electrocardiographic, echocardiographic, lab and tomographic findings are described. The authors suggest a pharmacokinetic mechanism which could be responsible of a "paradox effect" (a powerful and dangerous effect of the drug when given in low dose) and they wonder whether in case of allergic reactions should it be better not to stop the infusion of the thrombolytic drug and be more liberal with the "symptomatic" drugs. Tha patient is still alive and the clinical conditions slowly progressing.
authors.affiliation: Divisione di Cardiologia-UCC, Azienda Ospedaliera E. Morelli, Sondalo, Sondrio.
authors.forename: F
authors.initials: F
authors.lastname: Fedeli
authors.forename: D
authors.initials: D
authors.lastname: Skouse
authors.forename: A
authors.initials: A
authors.lastname: Messina
mesh_terms: D002543:Cerebral Hemorrhage / Q000139:chemically induced* / Q000000981:diagnostic imaging; D004305:Dose-Response Relationship, Drug; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy*; D013300:Streptokinase / Q000008:administration & dosage / Q000009:adverse effects*; D015912:Thrombolytic Therapy; D014057:Tomography, X-Ray Computed
chemical_list: D005343:Fibrinolytic Agents; D013300:Streptokinase
vernacular_title: Emorragia cerebrale da "bassa dose" di streptokinasi: paradosso farmacologico? Descrizione di un caso clinico.